Sereeyotin Jariya, Robinson Hayley, Detsky Michael E, Soong Christine, Kennedy Erin, Eta-Ndu Catherine, Burry Lisa, Shah Sumesh, Mehta Sangeeta
Department of Anesthesiology, Division of Critical Care Medicine, King Chulalongkorn Memorial Hospital, Bangkok, Thailand.
Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.
Can J Anaesth. 2025 Feb;72(2):334-344. doi: 10.1007/s12630-024-02890-3. Epub 2025 Jan 3.
The use of patient/family-centred written summaries to supplement verbal information may be useful to improve knowledge and reduce anxiety related to patient transfer from the intensive care unit (ICU) to a hospital ward. We aimed to identify essential elements to include in an ICU-specific patient-oriented discharge summary tool (PODS-ICU).
We conducted a mixed methods study. Participants were ICU patients who were transitioning to a hospital ward and clinicians. We used a validated questionnaire to measure the relocation stress of patients, and standardized questions to qualitatively explore patients' needs during the transition, as well as perspectives of clinician stakeholders. Inductive thematic analysis was used for the qualitative analysis.
We recruited 22 participants, including ten patients and 12 clinician stakeholders. Of ten patients, 50-100% reported positive experiences during the transition and 10-30% reported negative experiences. From all participants' perspectives, we identified the following essential elements for the PODS-ICU: the reason for transition, a summary of the ICU course, a clinical update, destination ward details, medication reconciliation, a future care plan, and the planned follow-up by the ICU outreach team. Family presence and earlier notification of an upcoming transfer were identified as support needs to help patients prepare mentally and reduce transfer anxiety. Moreover, using positive communication with patients when providing transfer details and using the brief standardized transfer tool were recommended to improve transition care.
We identified informational gaps in patient and family knowledge at the time of transfer from the ICU to a ward, which informed essential elements for the PODS-ICU. The PODS-ICU may reduce transfer anxiety and improve care during the transition from the ICU.
使用以患者/家庭为中心的书面总结来补充口头信息，可能有助于提高知识水平，并减少与患者从重症监护病房（ICU）转至医院病房相关的焦虑。我们旨在确定特定于ICU的以患者为导向的出院总结工具（PODS-ICU）中应包含的基本要素。
我们进行了一项混合方法研究。参与者为即将转至医院病房的ICU患者和临床医生。我们使用经过验证的问卷来测量患者的转院压力，并使用标准化问题定性地探索患者在转院过程中的需求以及临床医生利益相关者的观点。定性分析采用归纳主题分析法。
我们招募了22名参与者，包括10名患者和12名临床医生利益相关者。在10名患者中，50%-100%报告在转院过程中有积极体验，10%-30%报告有消极体验。从所有参与者的角度来看，我们确定了PODS-ICU的以下基本要素：转院原因、ICU病程总结、临床最新情况、目的地病房详细信息、用药核对、未来护理计划以及ICU外展团队的计划随访。确定家属在场和提前通知即将进行的转院是帮助患者做好心理准备并减少转院焦虑的支持需求。此外，建议在提供转院细节时与患者进行积极沟通，并使用简短的标准化转院工具，以改善转院护理。
我们确定了患者和家属在从ICU转至病房时知识方面的信息差距，这为PODS-ICU的基本要素提供了依据。PODS-ICU可能会减少转院焦虑，并改善从ICU转院期间的护理。
